Provider Demographics
NPI:1174673842
Name:DALY-EYTEL, NOREEN (LCMHC)
Entity Type:Individual
Prefix:
First Name:NOREEN
Middle Name:
Last Name:DALY-EYTEL
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 762
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NH
Mailing Address - Zip Code:03841-0762
Mailing Address - Country:US
Mailing Address - Phone:603-490-1904
Mailing Address - Fax:
Practice Address - Street 1:20 MARY E CLARK DR
Practice Address - Street 2:SUITE 6A
Practice Address - City:HAMPSTEAD
Practice Address - State:NH
Practice Address - Zip Code:03841-2292
Practice Address - Country:US
Practice Address - Phone:603-490-1904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH492101YM0800X
MA5312101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH14Y011097NH01OtherBEHAVIORAL HEALTH NETWORK